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PTSD, psychotropic medication increase dementia risk

PTSD diagnosis was associated with increased risk for dementia among veterans, which varied with use of psychotropic medications.

“Emerging research indicates that PTSD might be a major risk factor for the development of dementia among older adults,” Francis Mawanda, MBChB, PhD, of the University of Iowa, and colleagues wrote. “Yet, prior research failed to consider the potential impact of psychotropic medication use commonly encountered with a diagnosis of PTSD among U.S. veterans.”

To assess associations between PTSD, psychotropic medication use and risk for dementia, researchers evaluated a nationwide sample of U.S. veterans (n = 417,172) aged 56 years or older. Study participants did not have a diagnosis of dementia or mild cognitive impairment at baseline.

PTSD diagnosis significantly increased risk for dementia diagnosis (HR = 1.35; 95% CI, 1.27-1.43).

Researchers found significant interactions between PTSD diagnosis and use of selective serotonin reuptake inhibitors (SSRIs) (P < .001), novel antidepressants (P = .014), and atypical antipsychotics (P < .001) on dementia risk.

Veterans diagnosed with PTSD and prescribed SSRIs, serotonin-norepinephrine reuptake inhibitors (SNRI), or atypical antipsychotics were more likely to be diagnosed with dementia, with hazard ratios ranging from 1.99 for SSRIs to 4.21 for atypical antipsychotics, vs. veterans without PTSD not using psychotropic medication.

Veterans with PTSD not using psychotropic medications also had increased risk for dementia (HR = 1.55; 95% CI, 1.45-1.67).

Use of benzodiazepines or SNRIs at baseline was associated with significantly increased risk for dementia diagnosis, regardless of PTSD diagnosis.

“Although our results showed significant independent and effect modifying impacts, the association between psychotropic medication use and the risk of dementia remains an area for further inquiry,” the researchers wrote. “Thus, we recommend further research accounting for dosage, duration, and indications for use to determine whether the independent and the effect modifying impacts of psychotropic medication use on the risk for dementia are due to differences in PTSD severity and symptomatology, other psychiatric comorbidity, or whether they represent independent and direct effects on dementia neuropathogenesis.” – by Amanda Oldt

Disclosure: The researchers report no relevant financial disclosures.